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Introduction: After cessation of smoking, the best way to prevent health-threatening conditions is to treatment of obesity. Also, obesity treatment, cause alleviation or cure of other diseases. Bariatric surgery in selected obese patients is the best option for preventing health-threatening conditions. Despite the health benefits, this method of treatment -just like other surgical procedures- may be associated with various side effects. Case Presentation: A 55-year-old female with BMI of 46.5 underwent laparoscopic Omega Gastric bypass surgery. She was admitted due to dyspnea and pulmonary embolism 14 days later. In conducted surveys, platelet count was less than 25,000. In multiple assessments, no cause found for the thrombocytopenia. Corticosteroids prescribed for her with the diagnosis of ITP; which fully responded to treatment. Conclusions: Thrombocytopenia is a rare complication of gastric bypass surgery. Managements include rule out of other causes of thrombocytopenia and medical treatment.

Background: Prospective studies evaluating outcome of laparoscopic Heller myotomy and Dor fundoplication for esophageal achalasia are less in Asian people. Objectives: This study conducted to evaluate the results of laparoscopic cardiomyotomy and partial fundoplication for achalasia. Patients and Methods: Thirty patients who underwent Heller myotomy for achalasia via laparoscopy in Alzahra hospital Isfahan, Iran were recorded prospectively (2009 - 2013). Median follow-up was 18 months. Symptoms including dysphagia, regurgitation, chest pain and weight loss were recorded before and after operation. Also, previous treatment for achalasia such as endoscopic pneumatic dilatations and intrasphincteric injection of botulinum toxin or other component, duration of symptoms and duration and complication of operation was recorded. Results: Among 30 patients, there were 13 (43.3%) females and 17 (56.7%) males, and mean age was 40.8 years (range, 20 - 68 years). The operations were finished laparoscopically in all patients. Mean operative time was 137 ± 36.2 minutes. The patients were symptomatic for at least 30 months before referring for surgery. There are some difficulties in dissection in cases who received Ethanolamine or Botholinum Toxin injection as non-surgical treatment before that. Mean hospital stay was 2.45 days. Regurgitation, chest pain and heartburn relieved significantly in median follow up of 18 months, in 100%, 66.6% and 70%, respectively (P < 0.001, P < 0.01 and P < 0.01, respectively). At that time, except for two (6.6%) patients, all other patients had improvement in dysphagia (P < 0.001) .The mucosa in two (6.6%) of patients was perforated on the gastric end of the xylotomy. The perforations were repaired laparoscopically with single suture without postoperative leak. Conclusions: Our study showed that laparascopic Helermyotomy with Dor fundoplication result in significant relief of dysphagia. Overall clinical symptoms indicate improvement in patient functional status during 18-month follow-up.

Introduction: Although thymoma is the most common anterior mediastinal tumor, only 5% of thymoma cases develop pure red cell aplasia (PRCA). Case Presentation: In this article we have reported a 59-year-old man with a large anterior mediastinal mass (diameter of 10 cm) and severe anemia, that thymoma and pure red cell aplasia have been demonstrated by histopathologic and hematological examination. Despite the large mass, a complete video-assisted thoracoscopic surgery (VATS) thymectomy and combinational medical therapy were performed for him successfully. Aplasia remission occurred 6 months after thymectomy and his hemoglobin level reached to 13 g/dL. Conclusions: We believe that a complete resection in combination with medical therapy is necessary to achieve total remission of PRCA symptoms and conclude that VATS thymectomy is an effective and technically feasible procedure for surgery without any contraindications about the size of the thymoma in these patients.